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'Engaged, empowered staff are the key to better patient care'

The Point of Care started in 2006 with a story - well, two stories actually.

The mothers of two of my friends, both in their late eighties, were admitted to hospital, one after a fall at home, the other with suspected community-acquired pneumonia. The hospitals were different but their stories were virtually identical.

Both women were widows, who had been living full, independent lives in their own homes. Both were in hospital for seven weeks and, in the course of that time, they got progressively more sick, more dependent, more disorientated, more anxious and more fearful. They were both eventually discharged home but neither recovered her former life. They had both taken a step down - they were more frail and less confident, and were not able to get back what they had lost in hospital.

Bad things had happened to both of them: they were moved many times, one of them had C difficile and the other endured three days of severe pain from impacted faeces. But, their daughters said, the worst thing for them was feeling there was not anyone they could trust to look out for their mother, to make sure she was safe and cared for properly. When we talked about their mothers’ experiences we asked ourselves: “why is it like this?” “How did we get to this place where hospitals feel like huge systems in which ordinary ways of relating, human values and emotions are overlooked?”

The Point of Care Foundation grew from these and other stories - and from wanting to make a difference. The first phase of the work was at The King’s Fund where Joanna Goodrich and I researched and published work on two related questions: what do we know about patients’ experience in hospital? Are there any effective methods of protecting patients inside these systems and improving their experience of care that are supported by good research evidence?

Last year the programme at The King’s Fund ended; the Point of Care Foundation is now an independent charity. Our mission is to find and promote effective methods for improving patients’ experience of care by influencing policy makers, disseminating what we know about the methods that work and helping organisations on the ground apply them. The strength of evidence that staff experience and patient experience are related has encouraged us to widen our focus. We have just published our report on this topic - Staff Care: How to Engage Staff in the NHS and Why it Matters (The Point of Care Foundation, 2014).

We start from the perspective of the patient, our interest is in improvement that involves everyone in the system that they interact with, nurses, doctors, therapists, managers or non-clinical support staff. Our work has been mainly with acute hospitals and a few hospices but because we believe the same problems occur in mental health, primary care and community services, we are planning to extend to those areas.

Nurses are not always perfect. But neither is the profession broken. That’s the message that came out from the chief nursing officer for England’s summit last week. (See pages 2 and 3 for news from the summit.)

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